AGENCIES were not aware murdered toddler Harry House and his 'vulnerable' mother were living with a violent man who was considered a potential risk to women and children, a report says.
An independent serious case review by the Dorset Safeguarding Children Board into the death of two-year-old Harry, who was killed by his mother's then partner Joseph Eke at their Broadmayne home, says although the death could not be predicted there were "lost opportunities" to identify problems.
Harry's mother Lauren O'Neill was a vulnerable young parent when she met Eke, a drug abuser, recently released from prison. He was known to the authorities because of his past – but his new family set-up appears to have gone under the radar.
Although information came out during the three-and-a-half months Eke was living with them that Harry might be at risk "no agency had a complete picture of the nature of family relationships and what the implications might be".
Even police, who had been made aware of a domestic incident, assumed the man living there was Harry's father, who has the same first name to Eke, pictured below.
The murder was committed in May 2016 and Eke, 22, was convicted following a trial in June 2017. He was sentenced to a minimum of 18 years in prison.
Eke was found guilty of fatally kicking and punching Harry a number of times while Ms O'Neill had popped out to the shop.
His trial heard a “pattern of physical abuse” started to emerge from when Eke moved in with Miss O’Neill.
The report says although Harry's mother had a difficult time as a child and in her teenage relationships there was little indication of any problems with the pregnancy or with her relationship with Harry's father.
She had not lived with Harry's father but had been in a relationship with him for before separating when Harry was two.
Harry was said to be developing normally.
Ms O'Neill, 22, began a relationship with Eke, 21, when there was a "significant change in the dynamics of this family".
The report says: "We now know that (Eke) had a complex and sometimes violent past. He had a history of mental health issues. When he started his relationship with (Harry's mother) he had just been released from prison; he had been accused of domestic violence in his previous relationship and was known to have drug and alcohol issues."
It adds: (Harry's mother) was a vulnerable young parent...her early history indicated that she had issues in her own childhood likely to impact on her adult relationships and her choice of partner."
In the months leading up to Harry's death there were a number of events, which included Harry's mother visiting her GP five times in a month, Eke being threatened by Harry's father, health visitors having difficulty contacting Harry's mother, a domestic incident between Eke and Harry's mother, and Harry suffering a serious facial cut.
The report says taken in isolation, none of these events caused the professionals concerned to consider that Harry was at risk of harm. But no agency had a complete picture of what was happening.
Missed opportunities highlighted included:
- GP did not inquire about change in circumstances when Ms O'Neill visited five times in a month. In hindsight, it was pointed out the symptoms might indicate she could be the victim of domestic abuse or suffering emotional problems
- 'Incomplete picture' of family following dispute involving Harry's father and Eke. Agencies focused on tension between Harry's father and mother and at this time did not know Eke was living at family home. Health visitor couldn't access Ms O'Neill's history and telephoned her instead of making home visit
- Police failed to identity Eke was living with Harry and his mother during a second domestic incident involving a drunk Ms O'Neill. If checks had been done social workers would have been alerted
- Health visitors couldn't contact Ms O'Neill and weren't aware she had moved, this wasn't followed up as case was being shared by two staff. Once aware, the new team were waiting for updated address to visit when Harry died
- An incident where Harry suffered serious facial cut (whilst alone with Eke), even if it was an accident, should have been regarded as concerning and safeguarding advice sought. Harry should have been asked by hospital staff how he has sustained the injury. Eke was found not guilty of causing this injury
- Health visitors were not made aware of the above incident as it was not logged immediately at the GP surgery (possible system problems)
- An assessment by children's social care in response to earlier domestic incident and unearthing new information about the family situation was not 'robust' enough. Subsequent background checks on Eke were attempted but not done correctly. Harry died two weeks after the social care case was closed. Although his death could not have been predicted, there was information available which said Eke posed a risk
- Social workers speaking to Harry directly or asking about any unusual behaviour might have turned up more information
- There was no communication between social worker and Harry's father about contact, or with Eke about a domestic abuse referral
AGENCIES have made changes to try and minimise the chance of such a tragic case happening again.
Written by the Dorset Safeguarding Children Board, the review set out to establish what can be learned from the events leading up to Harry's death, and the how agencies involved with the family, could have done things differently.
Dorset’s Safeguarding Children Board (DSCB) is responsible for making sure that any findings are translated into learning.
Independent Chairman of the Board Sarah Elliott, said: “This was a very tragic case and I’d like to express our condolences to the family.
"The review, which examined the detailed circumstances of this case and each agency’s involvement with the family, has allowed us to look at how we all work with vulnerable families and share information with each other. We have highlighted where lessons can be learned, in particular, improving our knowledge of, and response to, domestic abuse.
“Although there were many agencies and services working with this family, it appears that there was not one particular service or agency that looked at the whole picture. This is not good enough.
“Since this devastating case, for which the offender has been brought to justice and is serving a lengthy prison sentence, agencies have been working very hard to address the areas highlighted in the review and change the way they operate. It’s vital that the right information is shared with the right people, at the right time, to reduce the risk of a similar case happening again.”
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